Why the study?
Previous studies have often focused on single-time obesity measurements, neglecting how changes over time and their cumulative effects influence stroke risk.
Does a consistently high waist circumference trajectory predict incident stroke better than other obesity indices in adults aged ≥45 years?
Does a consistently high waist circumference trajectory predict incident stroke better than other obesity indices in adults aged ≥45 years?
Sustained high waist circumference is a superior predictor of incident stroke compared to other traditional and novel obesity indices, highlighting the importance of long-term waist circumference monitoring.
High waist circumference trajectory may signal higher stroke risk in adults ≥45 years; leaves open superiority over other obesity indices for prediction.
BACKGROUND: While obesity is a recognized stroke risk factor, traditional measures like body mass index (BMI) have limitations in assessing body fat distribution. Novel central obesity indices-including waist-to-height ratio (WHtR), body roundness index (BRI), conicity index (CI), a body shape index (ABSI), and weight-adjusted waist index (WWI)-offer accessible alternatives reflecting visceral fat. However, previous studies have often focused on single-time obesity measurements, neglecting how changes over time and their cumulative effects influence stroke risk. METHODS: This prospective cohort study utilized longitudinal data (2011-2018) from the China Health and Retirement Longitudinal Study (CHARLS). We analyzed 5,896 adults aged ≥45 years without baseline stroke. Seven obesity indices (waist circumference [WC], BMI, WHtR, BRI, CI, ABSI, WWI) were measured at baseline (Wave1, 2011-2012), Wave2 (2013), and Wave 3 (2015). Their longitudinal trajectories from 2012 to 2013 and then to 2015 were modeled using K-means clustering. Their relative change was calculated from 2012 to 2015. Multivariable logistic regression evaluated associations between these obesity measures and incident stroke, adjusting for demographics, lifestyle, and comorbidities. RESULTS: As of the 2018 survey, 426 participants (7.23 %) experienced incident strokes. Baseline WC was significantly associated with stroke risk: each 1 cm increase corresponded to a 1 % higher risk (OR =1.01, 95 % CI: 1.001-1.02), and participants in the highest WC quartile had a 37 % greater risk compared to those in the lowest quartile (OR = 1.37; 95 % CI: 1.01-1.87). Other baseline obesity measures did not show significant associations. Regarding recent measurements in 2015, only the second quartile of ABSI was significantly associated with stroke risk (OR = 1.36; 95 % CI: 1.01-1.83 versus the first quartile). Crucially, individuals with a consistently high WC trajectory had a 27 % higher risk of stroke compared to those with a low trajectory (OR = 1.27, 95 % CI: 1.02-1.58). In contrast, relative changes in all indices were not associated with stroke risk. CONCLUSION: Baseline WC and a sustained high WC trajectory are significant predictors of stroke, outperforming other obesity indices. This underscores the critical importance of long-term waist circumference monitoring and management in stroke prevention strategies for middle-aged and older adults.
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Liu et al. (2025) studied this question.
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